HPPA500 E-Portfolios -Reflection

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This is my first time doing a SOAP note. I feel generating differential diagnoses and plans are most challenging parts for this exercise. Before we have a final diagnosis, it is important to consider all possibilities of medical problems that relate to this patient with headache. First, we have to think about those conditions which are common and which present in the common manifestations. Second, we think about those conditions which are common but which may present in an uncommon way. Third, consider those conditions which are uncommon but which present in the common way. Forth, consider medical conditions which are not only uncommon but also present in an uncommon way. For example, in this headache case, differential diagnose includes: primary cough headache, primary exertional headache, headache associated with sexual activity, benign thunderclap headache, intracerebral hemorrhage, and subarachnoid hemorrhage. After we have more findings on history and physical examination and after tests like head CT done, we can shortlist these possibilities. After a normal CT result, we rule out SAH. And the plan is to do a lumbar puncture for the patient, and treated with preexercise propranolol. Overall, considering the various diagnosis regarding the various possibilities are very helpful to the patient in deciding the further action.